Pecuniversity of Technology

PECUNIVERSITY OF TECHNOLOGY

(A deemed to be University)

Sector 12, Chandigarh

Phone No. 0172-2753090, Fax No. 0172-2745175 /

APPLICATION FORM FOR FACULTY POSITIONS

Name of the PostApplied for: ______

Department Applied for: ______
Area of Specialization: ______
Advertisement No. : ______dated: ______/ Affix Passport size Photograph

PART A: GENERAL INFORMATION AND ACADEMIC BACKGROUND

1. / Name in Full (Block Letters):
2. / Father’s/Mother’sName:
3. / Date of Birth:
4. / Nationality:
5. / Gender:
6. / Marital Status:
7. / Permanent address: / Address for Correspondence:
8. / Telephone Number:
Mobile number:
9. / E-mail Id:
10. / Please, state whether you belong to SC/OBC/Differently-abled/General category(Attach relevant certificate from the competent authority prescribed under Govt. rules wherever required):
11. / Are you willing to accept the minimum initial pay offered, if not, state what is the lowest initial pay that you would accept:
12. / Present post held with designation & name of the organization where employed:
13. / Present salary with pay band and Academic Grade Pay:
14. / Were you at any time declared medically unfit, asked to submit your resignation, discharged or dismissed from Government or private service:

15. Academic Qualifications (Matric till post graduation):

Examinations / Name of the Board/ University / Year of Passing / Percentage of Marks / CGPA Obtained / Division / Class / Branch/Subjects/Specialization
High School/Matric/ Secondary
Intermediate/ Sr. Secondary
Graduation / B.E./ B.Tech.
B.A./B.Sc.
Post Graduation / M.Sc.
M.E./ M.Tech/M.Phil.
Other examinations,
if any

16. Research Degree(s):

Degrees / Topic of thesis / Date of Award / University
Ph.D.
D.Sc/D.Litt

For the following items use separate sheets(as Annexures) wherever required in the format indicated. All Annexures should be consecutively arranged and must bear your name and be authenticated with your signature.

17. Previous Appointments held:

Name of employer / Desig- nation / Nature of
appointment (Regular/ Fixed term/Temporary / Adhoc /Contractual) / Nature of
Duties / Pay-
Scale / Date / Total Duration / Reasons of Leaving
From / to / Y / M / D

18. Period of teaching experience:

P.G. Classes (in years) …………….. U.G. Classes (in years) …………………….

19. Research Experience excluding years spent in MTech /MPhil /PhD (In years): …………….

20. Fields of Specialisation under the Branch/Subject:

(a)……………………..

(b)………………………

(c)……………………..

21. AcademicStaffCollege Orientation/Refresher and other Courses*attended:

Name of the Course / Place / Period / Duration / Organized by
From / To / Total

* summer/ winter schools/ short term course/ other appropriate continuing education programmes of comparable quality as may be specified or approved by AICTE

22. Development of Course material/ Curricula:

Sr No / Short Description

PART B: ACADEMIC PERFORMANCE

23. Courses Taught

S. No. / Course/Paper / Level (UG/PG) / No. of Times / Mode of teaching (Conventional / ICT)

24. CO-CURRICULAR, EXTENSION, PROFESSIONAL DEVELOPMENT RELATED ACTIVITIES

Please mention your contribution to any of the following:

S. No. / Type of Activity
(i)Co-curricular/Extension and field based Activities
(ii)
(ii) Contribution to Corporate Life and Management of the Institution
(iii) Professional Development Activities

PART C: RESEARCH, PUBLICATIONS ANDACADEMIC CONTRIBUTIONS

Please see Annexure -I at the end of this form for detailed instructions before filling this section.

Published papers in Journals:

S.
No. / Title with page Nos. and date of publication / Journal / Publisher / Location / ISSN/
ISBN No. / Whether peer reviewed. Impact Factor, if any / Source of Impact factor / No. and name of Co-authors / Whether you are the
First author / Corresponding Author / Supervisor /Mentor

B. (i)Articles/Chapters published in Books:

S.
No. / Title with page Nos. and date of publication / Book Title, editor & publisher / ISSN/
ISBN No. / Whether peer reviewed / No. of Co-authors / Whether you are the
First author / Corresponding Author / Supervisor /Mentor

(ii)Full Papers published in Conference Proceedings :

S.
No. / Title with page Nos. and date of publication / Details of Conference / ISSN/
ISBN No. / No. of Co-authors / Whether you are the
First author / Corresponding Author/ Supervisor/ Mentor

(iii)Books Published as single author or as editor:

S.
No. / Title with page Nos. and date of publication / Type of Book & Authorship / Publisher & ISSN/
ISBN No. / Whether peer reviewed / No. of Co-authors / Whether you are the main author

C. Ongoing and Completed Research Projects and Consultancies

S.
No. / Title / Agency / Period / Grant
(Rs. Lakh) / No. of
Co-PI / Whether you are the PI/Co-PI
Total / Received

S.
No. / Title / Agency / Period / Grant
(Rs. Lakh) / Whether policy document/ patent as outcome / No. of
Co-PI / Whether you are the PI/Co-PI
Total / Received

D. Research Guidance

S No / Research Level / Number Enrolled / Thesis Submitted / Degree Awarded / Name(s) in correct order of
Guide / Co-guides
MTech/M. Phil or Equivalent
Ph.D or Equivalent

E. (i) Training Courses, Teaching-Learning-Evaluation Technology Programmes, Faculty

Development Programmes (not less than one week duration):

S.No. / Programme / Period/Duration / Organized by

E. (ii) Papers presented (but not published) in Conferences, Seminars, Workshops, Symposia:

S.
No. / Title of the Paper presented / Title of Conference/
Seminar along with date of the event / Organized by / Whether International/ National /State /Regional/
College or University Level

E. (iii)Invited Lectures and Chairmanships at National or International Conference /Seminar etc.:

S.
No. / Title of Lecture/ Academic Session / Title of Conference/Seminar etc.. along with date of the event / Organized by / Whether International/ National

PART D: OTHER RELEVANT INFORMATION

(i) Please give details of any other credential, significant contributions, awards received etc. not mentioned earlier.

S.No. / Details (Mention Year, value etc. where relevant)

(ii)List of referees: (At least three names of referees with their complete addresses along with e-mail id. Referees should be persons with or under whom the candidate has worked and one of the referees should be from the last organization/ institute served. Referees should not be close relative of the candidate.)

………………………..
………………………..
………………………..

LIST OF ENCLOSURES: (Please attach, copies of certificates, sanction orders, papers etc. wherever necessary)

SrNo / Annexure No / Page No / Sr No / Annexure No / Page No
1 / 6
2 / 7
3 / 8
4 / 9
5 / 10

I certify that the information provided is correct and if at any stage it is found to be incorrect or false, my candidature/ selection would be cancelled.

Signature of the applicant

Place & Date

NB. The self-assessment scores are subject to verification by the PEC Scrutiny cum Verification Committee and Selection Committee.

Note:Types of Supporting documents

Supporting documents (self attested photocopies) such as those given below will be acceptable (wherever available) for various achievements claimed in the application.

Reprints of papers published in journals/conference proceedings etc.
Correspondence indicating corresponding author of paper, if available.
Proof of journals/books having ISSN/ISBN/Impact factor.
Proof of journals/books being refereed/peer reviewed/indexed.
Cover page of conference proceedings/books etc.
Copies of cover page of books and first few pages of chapters contributed.
Copy of notification/sanction letters/amount of grant mobilized for research projects/consultancy projects etc.
Copy of notification indicating PI/Co-PI and/ or Guide/Co-guide.
First page of thesis indicating guide/co-guide.
Cover page of MTech/MPhil/PhD thesis completed leading to award of degree.
Copies of certificates of training courses/schools/conferences etc. attended.
Copies of certificates of papers presented (if available) alongwith reprints of papers.
Communication relating to lectures delivered/sessions chaired etc.